Multicomponent interventions including group exercise and vitamin D supplementation (high-risk population)
Health Care: Falls Prevention for Older Adults
Benefit-cost methods last updated December 2023. Literature review updated January 2018.
Group exercise programs for falls prevention aim to prevent falls by providing exercise classes that address risk factors. Vitamin D interventions for falls prevention prescribe daily supplements of vitamin D, aiming to improve bone density. Group exercise and vitamin D programs include both of these interventions.
In the included study, physiotherapists taught one or two classes weekly at an exercise hall or a gym. For the rest of each week, participants were assigned home-based exercises for 5 to 15 minutes daily. A variety of exercise types were offered, including balance-challenging, strengthening, and agility exercises. Participants also received one daily pill containing 800 IU of vitamin D3. The program was provided to community-dwelling older women with a history of falls and lasted two years.
ALL |
BENEFIT-COST | META-ANALYSIS |
CITATIONS |
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For an overview of WSIPP's Benefit-Cost Model, please see this guide. The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2022). The chance the benefits exceed the costs are derived from a Monte Carlo risk analysis. The details on this, as well as the economic discount rates and other relevant parameters are described in our Technical Documentation.
Benefit-Cost Summary Statistics Per Participant |
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|
Taxpayers |
$12 |
|
Benefits minus costs |
($2,012) |
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|
Participants |
$2 |
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Benefit to cost ratio |
($0.46) |
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Others |
$2 |
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Chance the program will produce |
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Indirect |
($649) |
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benefits greater than the costs |
23% |
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|
Total benefits |
($634) |
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|
|
|
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Net program cost |
($1,378) |
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|
|
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Benefits minus cost |
($2,012) |
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1In addition to the outcomes measured in the meta-analysis table, WSIPP measures benefits and costs estimated from other outcomes associated with those reported in the evaluation literature. For example, empirical research demonstrates that high school graduation leads to reduced crime. These associated measures provide a more complete picture of the detailed costs and benefits of the program.
2“Others” includes benefits to people other than taxpayers and participants. Depending on the program, it could include reductions in crime victimization, the economic benefits from a more educated workforce, and the benefits from employer-paid health insurance.
3“Indirect benefits” includes estimates of the net changes in the value of a statistical life and net changes in the deadweight costs of taxation.
Detailed Monetary Benefit Estimates Per Participant |
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Taxpayers |
Participants |
Others2 |
Indirect3 |
Total
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|
Falls |
Health care associated with falls |
$12 |
$2 |
$2 |
$6 |
$21 |
Mortality associated with falls |
$0 |
$0 |
$0 |
$34 |
$34 |
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Program cost |
Adjustment for deadweight cost of program |
$0 |
$0 |
$0 |
($689) |
($689) |
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|
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Totals |
|
$12 |
$2 |
$2 |
($649) |
($634) |
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Populations - Primary |
Earnings |
General population All people |
Falls |
Older adults at high risk of falling Adults aged 65 or over with one or more risk factors for falls, such as: a history of falls, gait problems, the use of walking aids, vertigo, Parkinson's disease, or the use of antiepileptic medication |
For more information on populations see the
Technical Documentation
Detailed Annual Cost Estimates Per Participant |
Program costs |
$594 |
2016 |
Present value of net program costs (in 2022 dollars) |
($1,378) |
Comparison costs |
$0 |
2016 |
Cost range (+ or -) |
30% |
Per-participant cost estimates are based on the program costs in the included study and are spread over two years to reflect the duration of this program. We estimate provider hours; apply the 2016 mean hourly wage estimate for Washington State reported by the Bureau of Labor Statistics (retrieved March 2018) for physical therapists; and increase wages by a factor of 1.441 to account for the cost of employee benefits. The intervention in the included study provided 156 hours of exercise class, with one or two physical therapists leading each session and 15 participants on average. For each participant, we include the cost of ankle cuff weights, vest weights, and a step-board. We assume daily vitamin D pills cost $119 per participant over two years.
The figures shown are estimates of the costs to implement programs in Washington. The comparison group costs reflect either no treatment or treatment as usual, depending on how effect sizes were calculated in the meta-analysis. The cost range reported above reflects potential variation or uncertainty in the cost estimate; more detail can be found in our Technical Documentation.
Benefits Minus Costs |
Benefits by Perspective |
Taxpayer Benefits by Source of Value |
Benefits Minus Costs Over Time (Cumulative Discounted Dollars) |
The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in discounted dollars. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment. |
Benefits by Perspective Over Time (Cumulative Discounted Dollars) |
The graph above illustrates the breakdown of the estimated cumulative benefits (not including program costs) per-participant for the first fifty years beyond the initial investment in the program. These cash flows provide a breakdown of the classification of dollars over time into four perspectives: taxpayer, participant, others, and indirect. “Taxpayers” includes expected savings to government and expected increases in tax revenue. “Participants” includes expected increases in earnings and expenditures for items such as health care and college tuition. “Others” includes benefits to people other than taxpayers and participants. Depending on the program, it could include reductions in crime victimization, the economic benefits from a more educated workforce, and the benefits from employer-paid health insurance. “Indirect benefits” includes estimates of the changes in the value of a statistical life and changes in the deadweight costs of taxation. If a section of the bar is below the $0 line, the program is creating a negative benefit, meaning a loss of value from that perspective. |
Taxpayer Benefits by Source of Value Over Time (Cumulative Discounted Dollars) |
Citations Used in the Meta-Analysis
Uusi-Rasi, K., Patil, R., Karinkanta, S., Kannus, P., Tokola, K., Lamberg-Allardt, C., & Sievänen, H. (2015). Exercise and vitamin D in fall prevention among older women: a randomized clinical trial. JAMA Internal Medicine, 175(5), 703-711.